Exposure over time to factors such as irritants, moisture, friction, shear and adhesives can lead to skin breakdown and conditions including:
Not only can these conditions affect patient/resident health and healing, they can also influence care costs and facility resources. And because they have shared risk factors, it’s not uncommon for multiple conditions to present simultaneously – further amplifying their impact.
MASD is a term that describes several types of damage that occur when skin is exposed to excessive moisture and/or irritants. With over-hydration, the stratum corneum (outer most layer of the epidermis) becomes more permeable, skin pH becomes more alkaline and inflammation occurs. In addition, friction forces are increased when skin is moist or wet, so skin is more susceptible to damage.
Moisture can come from sweating, wound drainage, urine or stool, saliva, or other body fluids. But some fluids such as liquid stool, gastric or pancreatic fluid are problematic, caustic irritants that can directly damage skin.
Rich in enzymes and with an alkaline pH, liquid stool is a powerful irritant that can easily disrupt the skin’s normal barrier structure. Severe inflammation follows and where epidermis is destroyed, the result is a painful injury that causes needless suffering and can interfere with recovery or quality of life
Pouch security is critical to the comfort and well-being of the patient/resident with a stoma, and maintaining intact skin is critical to pouch adherence. Problem stomas, poor stoma location and high-volume output, especially that of liquid stool, can contribute to skin injury that can rapidly progress to erosion.
This type of skin damage is often associated with wounds that produce large quantities of drainage, such as venous ulcers or infected wounds. Adverse skin changes can also be noted when dressings are unable to manage the volume of drainage, or not changed often enough. Once established, maceration is difficult to resolve, especially if exposure has been prolonged and skin changes are severe.
When skin is exposed to friction (from rubbing against a surface or itself), heat is generated and epidermal cells are rubbed away, triggering inflammation. If moisture is also present, frictional forces are increased. This combination of factors can result in superficial skin damage.
A pressure injury is localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. Moisture and friction are also known risk factors for pressure injury development.1
Medical adhesives are a critical part of healthcare, but can cause Medical Adhesive-Related Skin Injury, or MARSI – a prevalent but under-recognised complication that can be serious enough to require additional treatment. MARSI can cause pain, increase the risk of infection and delay healing – all of which can reduce a patient’s/resident’s quality of life.2 Skin tears, skin stripping and tension blisters are common but avoidable examples.
Finding the optimal solution for your skin integrity needs can often be confusing. 3M can help you protect patient skin like no other partner can, because we apply ingenuity to our innovations. We’re here to help guide the product selection process based on your needs and clinical challenges.
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